Symptomatic, radiological profile of patients with endobronchial aspergilosis: a descriptive study

Abdul Azeez A. M., Deepak U. G.


Background: Aspergillosis is a common presentation, involving respiratory system and is usually seen as a fungus ball that colonizes and grows into a pre-existing lung cavity, in the majority of cases secondary to pulmonary tuberculosis (PT). An endobronchial aspergilloma (EBA) is a rare disease, and another, but unusual, presentation of aspergillosis, characterized by the growth of Aspergillus species into the bronchial lumen. These two different presentations of aspergillosis can co-exist in the same patient. endobronchial aspergillosis, a variant of invasive aspergillus tracheobronchitis, a rare manifestation, where disease is limited to tracheobronchial tree without invasion of lung parenchyma and in many cases incidentally diagnosed, in a patient who had undergone a bronchoscopy to investigate haemoptysis, or for another reason.

Methods: Patients who were attending respiratory OPD with symptoms of cough with expectoration with immune compromised status or previous history of tuberculosis with abnormal chest X-ray were subjected to chest CT scan, with abnormal endobronchial mass in CT scan were further investigated with fibreoptic bronchoscopy and histopathological examination.

Results: 16 patients were diagnosed as endobronchial aspergilloma of which 11 patients were having past history of tuberculosis, 9 patients were having type 2 diabetes mellitus on treatment, 2 were having cardiac disease.

Conclusions: IATB is a rare manifestation caused by Aspergillus species affecting people with immunocompromised status or previous respiratory pathology like tuberculosis leading to formation of mass like growth obstructing the airway lead to respiratory distress and it should be taken as differential diagnosis in patients with previous respiratory pathology presented with mass like growth in bronchi.


Aspergillosis, Bronchus, Endobronchial

Full Text:



Meyer RD, Young LS, Armstrong D, Yu B. Aspergillosis complicating neoplastic disease. Am J Med. 1973 Jan 1;54(1):6-15.

Young RC, Bennett JE, Vogel CL, Carbone PP, Devita VT. The spectrum of the disease in 98 patients. Medicine. 1970 Mar 1;49(2):147-73.

Wu N, Huang Y, Li Q, Bai C, Huang HD, Yao XP. Isolated invasive Aspergillus tracheobronchitis: a clinical study of 19 cases Clin Microbiol Infect. 2010 Jun;16(6):689-95.

Barnes PD, Marr KA. Aspergillosis: spectrum of disease, diagnosis, and treatment. Infectious Dis Clin. 2006 Sep 1;20(3):545-61.

Kramer MR, Denning DW, Marshall SE, Ross DJ, Berry G, Lewiston NJ, et al. Ulcerative tracheobronchitis after lung transplantation. Am Rev Respir Dis. 1991;144:552-6.

Clarke A, Skelton J, Fraser RS. Fungal tracheobronchitis. Report of 9 cases and review of the literature. Medicine. 1991 Jan 1;70(1):1-4.

Denning DW, Riniotis K, Dobrashian R, Sambatakou H. Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: case series, proposed nomenclature change, and review. Clin Infectious Dis. 2003 Oct 1;37(Supplement_3):S265-80.

Denning DW. Commentary: unusual manifestations of aspergillosis. Thorax. 1995 Jul;50(7):812.

Tasci S, Glasmacher A, Lentini S, Tschubel K, Ewig S, Molitor E, et al. Pseudomembranous and obstructive Aspergillus tracheobronchitis: optimal diagnostic strategy and outcome. Mycoses. 2006 Jan;49(1):37-42.

Patel N, Talwar A, Stanek A, Epstein M. Tracheobronchial pseudomembrane secondary to aspergillosis. J Bronchol Interventional Pulmonol. 2006 Jul 1;13(3):147-50.

Putnam Jr JB, Dignani MC, Mehra RC, Anaisse EJ, Morice RC, Libshitz HI. Acute airway obstruction and necrotizing tracheobronchitis from invasive mycosis. Chest. 1994 Oct 1;106(4):1265-7.

Machida U, Kami M, Kanda Y, Takeuchi K, Akahane M, Yamaguchi I, et al. Aspergillus tracheobronchitis after allogeneic bone marrow transplantation. Bone Marrow Transplantation. 1999 Nov;24(10):1145.

Sayiner A, Kürşat S, Töz H, Duman S, Onal B, Tümbay E. Pseudomembranous necrotizing bronchial aspergillosis in a renal transplant recipient. Nephrol Dialysis Transplantation. 1999 Jul 1;14(7):1784-5.

Wallace JM, Lim R, Browdy BL, Hopewell PC, Glassroth J, Rosen MJ, et al. Pulmonary Complications of HIV Infection Study Group. Risk factors and outcomes associated with identification of Aspergillus in respiratory specimens from persons with HIV disease. Chest. 1998 Jul 1;114(1):131-7.

Hope WW, Walsh TJ, Denning DW. Laboratory diagnosis of invasive aspergillosis. Lancet Infectious Dis. 2005 Oct 1;5(10):609-22.